Autologous Stem Cell Transplant Should Remain Standard of Care for Certain DLBCL Patients, Expert Says

Video

Dr. Nirav Niranjan Shah explains the data behind why autologous stem cell transplant should remain the standard of care for patients with relapsed chemo-sensitive DLBCL.

As the cancer landscape moves toward CAR-T cell therapy for patients with relapsed chemo-sensitive diffuse large B-cell lymphoma (DLBCL), researchers looked at the role autologous stem cell transplant plays in this patient population and still found it to be the standard of care, according to data presented at the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Meeting.

In an interview with CancerNetwork®, a sister publication to CURE®, Dr. Nirav Niranjan Shah, from the Medical College of Wisconsin, discussed results of an analysis of this patient population that showed that autologous stem cell transplant still plays a role in these patients.

Transcription:

We looked at this population of patients who went into their transplant with a partial response, really to understand if there is a role to understand autologous stem cell transplant for this patient population in the CAR-T cell era. What we found through the registry was that the number of autologous stem cell transplants done were patients with diffuse large B-cell lymphomas had decreased 45% from 2017 to 2018.

This made us think that there might be some patients like this, who had a PET-CT partial response that didn't go to auto-transplant but probably got CAR-T cell therapy instead. So, we wanted to see what the outcomes for autologous transplant looked like.

What we found in our study was that the 5-year progression-free survival, whether you relapsed early in 12 months of diagnosis or relapsed late, the PFS was 41% at 5 years for both cohorts. We were encouraged by this number and it does show that autologous transplants do still have a role for patients with chemo-sensitive relapsed diffuse large B-cell lymphoma, even if they have only a partial response to the time of transplant.

Related Videos
For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
Dr. Andrea Apolo in an interview with CURE
Dr. Kim in an interview with CURE
Dr. Nguyen, from Stanford Health, in an interview with CURE
Dr. Barzi in an interview with CURE
Sue Friedman in an interview with CURE
Dr. Giles in an interview with CURE
Related Content